Open AccessEvaluation of Genotypes and Epidemiology of Spinal Muscular Atrophy in Greece: A Nationwide Study Spanning 24 Years
Author(s) -
Kyriaki Kekou,
Maria Svingou,
Christalena Sofocleous,
Niki Mourtzi,
Evangelia Nitsa,
George Konstantinidis,
Sotiris Youroukos,
Konstantinos Skiadas,
Marina Katsalouli,
Roser Pons,
Antigoni Papavasiliou,
Charalabos Kotsalis,
Evangelos Pavlou,
Athanasios Evangeliou,
Eustathia Katsarou,
Konstantinos Voudris,
Argirios Dinopoulos,
Pelagia Vorgia,
Georgios Niotakis,
Nikolaos Diamantopoulos,
Iliada Nakou,
Vasiliki Koute,
George Vartzelis,
George-Konstantinos Papadimas,
Constantinos Papadopoulos,
Georgios Tsivgoulis,
Joanne TraegerSynodinos
Publication year - 2020
Publication title -
journal of neuromuscular diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.366
H-Index - 23
eISSN - 2214-3602
pISSN - 2214-3599
DOI - 10.3233/jnd-190466
Subject(s) - medicine , sma* , spinal muscular atrophy , epidemiology , population , disease , context (archaeology) , retrospective cohort study , incidence (geometry) , genetic testing , age of onset , pediatrics , environmental health , biology , paleontology , physics , combinatorics , optics , mathematics
Background: Promising genetic treatments targeting the molecular defect of severe early-onset genetic conditions are expected to dramatically improve patients’ quality of life and disease epidemiology. Spinal Muscular Atrophy (SMA), is one of these conditions and approved therapeutic approaches have recently become available to patients. Objective: Analysis of genetic and clinical data from SMA patients referred to the single public-sector provider of genetic services for the disease throughout Greece followed by a retrospective assessment in the context of epidemiology and genotype-phenotype associations. Methods: Molecular genetic analysis and retrospective evaluation of findings for 361 patients tested positive for SMA- and 862 apparently healthy subjects from the general population. Spearman rank test and generalized linear models were applied to evaluate secondary modifying factors with respect to their impact on clinical severity and age of onset. Results: Causative variations- including 5 novel variants- were detected indicating a minimal incidence of about 1/12,000, and a prevalence of at least 1.5/100,000. For prognosis a minimal model pertaining disease onset before 18 months was proposed to include copy numbers of NAIP (OR = 9.9;95% CI, 4.7 to 21) and SMN2 (OR = 6.2;95% CI, 2.5–15.2) genes as well as gender (OR = 2.2;95% CI, 1.04 to 4.6). Conclusions: This long-term survey shares valuable information on the current status and practices for SMA diagnosis on a population basis and provides an important reference point for the future assessment of strategic advances towards disease prevention and health care planning.